Medicaid Certification & Compliance Data Analyst (REMOTE)

Job Title: Medicaid Certification & Compliance Data Analyst (REMOTE)
Location: Raleigh, NC
Duration: 12+ Months

Job Description:

The Certification Data Analyst role reports to the Certification and Compliance Manager and participates in project team activities. The Certification Data Analyst (CDA) leads the development of outcome statements and operational reporting for Medicaid Enterprise System (MES) projects. This role collaborates with Business Leads, Project Teams, functional/matrix managers, vendors and other stakeholders to ensure that Medicaid and CMS criteria are met, and project tasks are delivered on schedule, within budget, and positioned for a successful MMIS/CMS Certification, consistent with Program Management guidelines/processes and CMS expectations.

The CDA will be responsible and play a key role in supporting the Leadership and Managers to maintain the relationship in planning and executing CMS certification activities in conjunction with project team implementing complex systems in support of the Client programs.

Key Responsibilities:

• Gather data from various sources, clean and transform it for analysis, and ensure data accuracy and quality.
• Apply statistical methods, techniques, and tools to analyze data, identify patterns, trends, and relationships, and draw conclusions.
• Administer and maintain outcome statements database.
• Create clear and compelling visualizations (charts, graphs, dashboards) to present data findings and insights in an easily understandable format.
• Draft MES outcome statements and metrics for the program and project teams.
• Identify problems, develop solutions, and implement data-driven strategies to improve business processes and outcomes.
• Maintain Operational Workbook Report (OWR) timelines.
• Collaborate with the Business Leads and Project Teams to create and update state- specific outcome statements.
• Contribute outcome statements to Advanced Planning Documents (APDs).
• Attend and facilitate meetings to present findings.
• Support designated project leads and Subject Matter Experts (SMEs)with certification questions.
• Attend CMS certification presentations and reviews.

Skills:

• CMS Medicaid Enterprise Systems or federal regulations.-Required-3-Years
• MMIS / CMS certification experience.-Required-3-Years
• Experience with spreadsheet tools like Microsoft Excel or Google Sheets.-Required-5-Years
• Experience using data to improve organizations.-Required-5-Years
• Experience implementing information systems in client facing role.-Required-5-Years
• CMS Medicaid Enterprise Certification Life Cycle process experience.-Required-3-Years
• Experience in healthcare related knowledge, ideally in analytics, reporting or related.-Highly desired-5-Years
• Implementation/SDLC methodologies, e.g. Agile, waterfall, hybrid and/or iterative-Required-3-Years
• Experience with data visualization software experience.-Required-5-Years
• Medicaid, MMIS, claims process or related experience.-Highly desired-3-Years
• Demonstrated experience using project tracking tools (Microsoft Project, (e.g. Jira, MITAPulse)-Required-3-Years